There are many different sports and orthopaedic surgeries which could require surgery to help patients heal and get back to their previous levels of activity.
It would be impossible to list them all here, but here are some of the most common.
ACL tears are arguably one of the most common types of sports injuries, and very often require surgery. This is because ACL tears rarely heal themselves and can’t be stitched back together to repair them.
Instead, patients with ACL tears require reconstruction surgery, during which the old ACL is removed and replaced with a ligament that is harvested from your own, or in some cases, a donor hamstring.
ACL surgery is usually recommended for athletes, or for patients who will be looking to get back to moderate to high levels of physical activity. The goal is to restore stability and range of motion in the knee joint, so that patients can continue to take part in the activities that they enjoy. It is generally very low risk, although there is a considerable recovery period, and it could take patients up to a year before they can return to high-level sports.
Meniscus tears are another very prevalent knee injury, particularly in athletes and those who play contact sports. “Meniscus tears are easily the second most common knee injury that I see,” says Mr El-Tawil.
The meniscus is a c-shaped pad of cartilage in the knee. Its main purpose is to act as a shock absorber and absorb impact to protect the bones and other structures within the knee. There are two menisci, and it is the medial meniscus that is most commonly torn as a result of a traumatic injury, or due to degenerative changes that happen over time.
The trouble with a meniscus tear is that if you are under the age of 20, it is unlikely to heal itself, and so surgical intervention is needed to repair the knee. This is a minimally-invasive, arthroscopic (keyhole) surgery where the meniscus is repaired inside the knee, in a procedure sometimes referred to as an ‘all-inside repair’.
Rehabilitation time for a meniscus repair can take between three and six months.
A stress fracture is an injury that normally forms part of a repetitive strain injury. This is because they tend to occur as a result of overuse.
When muscles get tired and weak, their ability to protect bones from impact is compromised. When these muscles and bones are then also subjected to the same type of impact over and over again, the bones can start to break. This is known as a stress fracture.
Some types of stress fractures need surgery to heal properly. In most instances, this involves using special equipment such as pins, screws or plates to support the bones in their new positions so that they can heal correctly. This is especially true in joints, which are more complicated than standard, single bones, making it more important that they heal perfectly.
Torn or detached rotator cuff
The shoulder has the widest range of motion of any joint in the human body. Unfortunately, this also makes it susceptible to injury.
The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus, which is the bone in the upper arm. The rotator cuff attaches the bone to the shoulder blade and facilitates movement. However, sudden movement, degeneration or impact can cause one or more of the rotator cuff tendons to tear or become detached from the bone. Athletes are particularly vulnerable to rotator cuff tears, particularly those that play sports like tennis or baseball.
Surgery for a torn or detached rotator cuff is usually recommended for athletes or people with moderate to heavily active lifestyles. The type of repair performed and your recovery period will depend on the size and position of the tear/detachment, and the quality of your tendon tissue and bone.
Osteochondral defect is the term used to describe a focal area of damage that involves both cartilage and underlying bone. They are most often associated with injuries that occur during to repetitive strain.
However, some studies suggest that there may be a genetic link between patients with the condition. While they can affect any joint in the body, they are most often seen in the knee.
The most common osteochondral defect is where a small piece of articular cartilage covering the bone has come away. It may be floating around in the knee joint, in which case, a surgical technique called fixation is used to find and relocate the cartilage back to where it should be. This will preserve the joint and eliminate symptoms. If this fragment isn’t able to be found, there are other surgical options to treat the joint.
Patella dislocation and maltracking
The patella is the official name of the kneecap — the small, floating bone located at the very front of the knee.
In a healthy knee, the patella glides up and down within a groove at the bottom of the thigh bone when you move around. However, if the muscles that hold the patella in its correct position become weakened, it can cause instability that causes the patella to be pulled out of the groove and towards the outer side of the knee — known as a knee dislocation.
Patella stabilisation surgery, also known as patella realignment, is a common orthopaedic surgery to stabilise and realign the patella following dislocation and misalignment of the knee cap.
Just like many orthopaedic surgeries, it is followed by intense physiotherapy to help strengthen the muscles in and around the knee, maintain your range of motion and increase the overall success of the surgery.